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Far too many children are diagnosed as having a urinary tract infection without objective proof, while others have a urinary tract infection which goes unrecognized. In about 2–20% of autopsies in children there is evidence of chronic pyelonephritis which has gone clinically unrecognized. In about 1–2% of female children (and about 6% of adults) who are apparently healthy without urinary tract symptoms, there is significant bacteriuria. However, it is fortunate that only a small proportion of these children go on to get chronic pyelonephritis and its recognized complications. Recent work (Ransley, et al.*) has shown that in some patients intrapapillary reflux occurs and is related to the development of chronic pyelonephritis. This probably accounts for some patients having recurrent urinary tract infections without the sequelae, while others proceed to show the radiological changes of chronic pyelonephritis with only a scant history of urinary tract infection.
KeywordsUrinary Tract Infection Recurrent Urinary Tract Infection Renal Tubular Acidosis Renal Agenesis Distal Renal Tubular Acidosis
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